| NPI | 1770153751 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAWN CLARK Clinical Director 239-939-3363 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| Additional Taxonomies | 251B00000X Case Management |
| Enumeration Date | 2021-06-30 |
| Last Update Date | 2023-07-03 |